The proposed project is a revised submission to the National Institutes of Health and will test technological innovations in non-pharmacological pain control for patients who have sustained significant physical trauma (i.e., internal or orthopedic injuries, or a combination of the two). The study will also perform laboratory studies to determine how virtual reality distraction and hypnosis can best be combined, and will also follow patients on a long-term basis to determine whether improved pain control during hospitalization has an impact post-discharge. Study 1 will test the impact that hypnosis delivered through immersive virtual reality technology has on the ongoing (background) pain and anxiety of patients hospitalized for trauma that includes internal trauma, bone fractures or both. Not only will we examine the impact of virtual reality hypnosis on pain and anxiety ratings, we will also determine if this intervention reduces opioid analgesic use, hospital length of stay and sleep problems, relative to a control condition consisting of virtual reality distraction and standard treatment. Further, patients will be followed at 6,12 and 24 months post-discharge with the purpose of determining whether improved pain control during hospitalization translates into health benefits with time. Study 2 will take the next step in our ongoing laboratory studies that investigate the impact of combining hypnosis and virtual reality distraction. Using a sample of college students undergoing thermally induced pain, we will determine if audiotaped hypnotic suggestions increase the sense of "presence" in an immersive virtual reality environment and decrease ratings of thermal pain. The proposed project is significant for a number of reasons as it will: 1) test a new technology that could potentially be applied to millions of patients in pain as it relies on sophisticated software rather than the presence of extensively trained clinicians, 2) test an approach that could ultimately prove cost-effective by reducing analgesic opioid use and hospital stay, 3) further theoretical work in pain control that can potentially produce the benefits above and 4) to form a bridge between advancements in acute pain and chronic pain. [unreadable] [unreadable] [unreadable]